Archive for February 2012

Does routine magnesium sulfate infusion improve outcome in tricyclic antidepressant overdose?

February 29, 2012, 11:30 pm

★☆☆☆☆

Tricyclic antidepressant poisoning treated by magnesium sulfate: a randomized, clinical trial. Emamhadi M et al. Drug Chem Toxicol 2012 Feb 7 [Epub ahead of print]

Abstract

The authors claim that they “evaluated the effect of magnesium sulfate in the treatment of TCA [tricyclic antidepressant] intoxication” by performing a randomized clinical trial. They had 72 subjects, a control group [N = …

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Recognizing venomous snakes

February 27, 2012, 11:50 pm

Coral snake

★★★½☆

Recognizing Dangerous Snakes in the United States and Candada: A Novel 3-Step Indentification Method. Cardwell MD. Wilderness Environ Med 2011 Dec;22:304-308.

Abstract

This paper presents a 3-step flowchart that can identify with reasonable accuracy poisonous snakes (crotalids or elapids) in the United States or Canada. The identification system uses features on the body of the snake, not the …

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Tox tunes #55: Heroin (The Velvet Underground)

February 26, 2012, 5:36 pm

This song — from the 1967 album The Velvet Underground & Nico — was controversial from the time it was first released. Wikipedia quotes critic Mark Deming on the reason why:

While ‘Heroin’ hardly endorses drug use, it doesn’t clearly condemn it, either, which made it all the more troubling in the eyes of many listeners.

Rolling Stone has ranked …

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Antidotes: a superb review

February 25, 2012, 3:20 pm

★★★★☆

Antidotes for toxicological emergencies: A practical review. Marraffa JM et al. Am J Health-Syst Pharm 2012 Feb 1;69:199-212.

Abstract

Although aimed primarily at hospital pharmacists, this superb review of the major toxicological antidotes would also be helpful reading for emergency physicians and nurses. The authors provide focused intelligent sections on toxic-alcohol poisoning, antidotes for calcium-channel blocker and β-blocker overdose, the …

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Methylene chloride: beware CNS depression and carbon monoxide toxicity

February 23, 2012, 11:46 pm

Methylene Chloride

★★★★☆

Fatal Exposure to Methylene Chloride Among Bathtub Refinishers — United States, 2000-2011. MMWR 2012 Feb 24;61:119-22.

Full Text

Methylene chloride is a halogenated hydrocarbon used as a paint stripper, degreaser, and metal cleaner. It is readily absorbed into the system when inhaled, and can be extremely toxic through a number of different mechanisms. Like most hydrocarbons, it causes …

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Cannabinoid hyperemesis syndrome: largest case series to date

February 22, 2012, 1:27 am

★★★½☆

Cannabinoid Hyperemesis: A Case Series of 98 Patients. Simonetto DA et al. Mayo Clin Proc 2012;87:114-119. 

Abstract

When TPR first discussed cannabinoid hyperemesis syndrome (CHS) last August, we noted that there had been only 31 cases reported in the medical literature up to that time. We immediately heard from a number of clinicians who said that this syndrome must be …

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Speakeasy Science: An essential blog for all tox fanatics

February 20, 2012, 7:20 pm

One of my favorite blogs is Speakeasy Science, written by Deborah Blum as part of the Public Library of Science (PLoS) Blogs Network. Blum —  author of the fascinating history The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York  — posts mostly about toxicology history, and the interaction of toxins with culture and …

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Lessons from the Courtroom: iatrogenic N-acetylcysteine overdose

February 20, 2012, 5:07 pm

My recent Emergency Medicine News column on iatrogenic N-acetylcysteine overdose is available online. To read it, click here.…

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Tox Tunes #54: Poisoning Pigeons in the Park (Tom Lehrer)

February 19, 2012, 2:05 pm

Tom Lehrer (b. 1928) had an eclectic career that included academic mathematics (he graduated magna cum laude from Harvard at age 19 and taught for many years at UC-Santa Cruz), a stint in the military (where he claims to have invented the jello shot), research at Los Alamos National Laboratory, and — last but certainly not least — creating …

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